Published online Oct 28, 2015. doi: 10.4254/wjh.v7.i24.2497
Peer-review started: January 28, 2015
First decision: March 6, 2015
Revised: September 27, 2015
Accepted: October 16, 2015
Article in press: October 19, 2015
Published online: October 28, 2015
Non-alcoholic fatty liver disease (NAFLD) is an emerging health concern in both developed and non-developed world, encompassing from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis and liver cancer. Incidence and prevalence of this disease are increasing due to the socioeconomic transition and change to harmful diet. Currently, gold standard method in NAFLD diagnosis is liver biopsy, despite complications and lack of accuracy due to sampling error. Further, pathogenesis of NAFLD is not fully understood, but is well-known that obesity, diabetes and metabolic derangements played a major role in disease development and progression. Besides, gut microbioma and host genetic and epigenetic background could explain considerable interindividual variability. Knowledge that epigenetics, heritable events not caused by changes in DNA sequence, contribute to development of diseases has been a revolution in the last few years. Recently, evidences are accumulating revealing the important role of epigenetics in NAFLD pathogenesis and in NASH genesis. Histone modifications, changes in DNA methylation and aberrant profiles or microRNAs could boost development of NAFLD and transition into clinical relevant status. PNPLA3 genotype GG has been associated with a more progressive disease and epigenetics could modulate this effect. The impact of epigenetic on NAFLD progression could deserve further applications on therapeutic targets together with future non-invasive methods useful for the diagnosis and staging of NAFLD.
Core tip: The interplay of environmental and host factors results in non-alcoholic fatty liver disease (NAFLD) development and influence its progression individually. Nevertheless, the physiopathology of this disease remains unclear, so this lack of knowledge avoids the development of new therapeutic approaches and non-invasive biomarkers. Epigenetics could be an interesting alternative to cover these issues, considering the amount of evidence accumulated in order to clarify its role on NAFLD.